Ask The Adjuster - Statement of Purpose:
This site is for anyone confused by the insurance process, insurance policies, claims or anything else in the world of insurance. We do NOT sell insurance here, nor do we refer you to a sales person.

Sounds really interesting, doesn't it? We all need insurance and need to understand what coverage’s we have but the most common advice out there is
"read your policy"! That should put you straight to sleep. Even if you are an insomniac, you probably still will not understand what your policy covers and does not cover.

It’s a safe bet that right now you are not insured as completely as you should be.

We will cover all lines of insurance, types of claims, damages, repairs, accidents, health, illness and any related topics you want to discuss.
We will discuss what coverage’s are available for any type of insurance you might need and why you would need it. What to do when you need your insurance policy.
How to make a claim and when NOT to.

We intend to simplify the language and talk in simple terms anyone can follow. Our primary direction and focus will be determined by you. So please click that green button and"AskTheAdjuster"!

Flooded car, should I accept repairs? Will it effect
my resale value? Title?

I was coming home at 1 am from my second shift job and I ran into some water that swept me off
the road and it filled my car interior up to my waist it also died and would not crank back even after
the water went down and we could get to it to have it gotten out with a tow truck.
Who took it to a Ford dealer at the insurance request.continues Click
here

The car is a 2006 Ford Fusion and it has 45,000, miles on it. They have informed me after changing the fluids in the car it starts and runs just fine. So the insurance wants the Ford dealer to do up the estimate on repairing it. I still owe about $17,000 on this car and I am afraid problems will arise later from this I also do not want a car title saying flood damaged or water damaged. This will hurt the value of my car if I ever needed to sell it or trade it in. Also I have the extended warranty service which I am sure after this they would not want to cover and mechanical problems that might later arise. I would like to know how I should handle this. I am really nervous about taking a chance on hidden damage.
Linda,
Kentucky

Answer:
Linda,
I am not sure when or how a car title gets labeled "Flooded" but that would be
a problem when you tried to sell the car. Also, you are probably legally required
to disclose something like that even if the title does not show it.

I would ask the Ford dealer if the warranty is still intact and get it in writing. I cannot image they would want to warranty a flooded car, there are so many things that can go wrong later; rusting wiring and metal, odors, etc.

How long was the car in water? Was the water clean? If the water was "grey" or "black" then I would really push hard for replacement or major repairs and cleaning. If the water was "clean" and
the car not submerged too long then repairs can probably be effective over the
long term. Let the dealer know he is going to be the one repairing it and honoring
your warranty for the life of this car. If they are willing, in writing, then
it is probably okay.
Good luck,
Scott
back

Extensive water damage from frozen pipe, what do
I do now?

Sometime during the latter part of January there was a cold snap in the
Boise, Idaho area. I live in another state and own a second home in the
area which is vacant when I am not in Idaho. I was there at the property
as recently as January 6th and all was well. continues Click
here

On February 2 I was notified
by the neighbor that water was flowing out from under the front door threshold
as well as from the garage onto the front porch and driveway. I immediately
called a local friend to shut off the water to the house and had him enter
the property whereupon he could see extensive water damage to the interior
including buckled hardwood flooring, soaked carpeting, fallen ceilings
and drywall and warped vinyl flooring. The water had apparently been leaking
for some time but had gone unnoticed due to snow and rain on the driveways,
etc. After having the water, gas and electric service turned off to forestall
further damage because of all the water in the walls and fixtures, and
since the weather was somewhat mild (above freezing even overnight), I
arranged to fly to Boise within the next few days. Meanwhile, I contacted
my insurance company and reported the incident to them. Upon arrival in
the area and visually assesing the damage, it appears that possibly a water
supply line to one of the upstairs bathrooms, or perhaps an angle stop
valve may have failed either due to freezing or some other reason. There
are many vacant homes in the area due to this rough economy and I have
not determined whether or not other owners have had issues like this. My
question is this; Since my insurance company will probably try to balk
at paying my claim, insisting cause of damage (still undetermined) is not
covered, what reasonable steps should I undertake (or avoid) to determine
the cause and commence removal of soaked carpets, drywall and flooring
materials (to stop further damage) while waiting for the adjuster to make
his inspection --which might take weeks, I am told? I don't want to hurt
my position re: my claim by disturbing the scene of damage, but neither
do I want to allow things to get worse due to inaction.
Thanks,
Rick -Idaho

Answer:
Rick,
Water damage from frozen or otherwise failed pipes and/or appliances IS covered. The only problem will be if you did not take steps to prevent this from happening while the home was vacant.

I hope you had left the heat on. Since you did not winterize you will need to document what you did do to protect the property like leaving the heat on, having a caretaker, etc. Get copies of your utility bills to help prove that the heat was on, also try to document all the times you or others were there between Jan 6 and Feb 2.

The adjuster should make an inspection much more quickly than weeks, did they tell you it would take that long? In either case you do need to do things right away to keep damages from getting any worse. Your insurance policy actually requires you to mitigate the damages as soon as possible (see your policy, Section 1 Conditions - Duties After Loss). See if your insurance company has any approved Water Restoration Contractors in your area, but if not get one anyway. Take digital photos of everything, good overviews of each room and then close ups of all damages. If the contractor finds a burst pipe (before the adjuster comes) photo it and keep it. Be sure to keep all receipts for any emergency or other repairs you do.

The quicker you get the water out and the structure dry the better, for you and the insurance company. Keep the Insurance company informed of everything you are doing, if an adjuster is not there, and document who and when you talked to them and what was discussed. There are some good forms for this in our Claims Money Kit.
Good luck,
Scottback

Katrina damage repaired, how do I collect the depreciation
they withheld?

I filed a claim when my home was heavily damaged by Hurricane Katrina in August 2005. I am around 95% complete with all repairs. Am I entitled to the deprication amount witheld by the insurance company and if so,how do I go about that.
Ron, Louisianasee response Click
here

Answer:
Ron,
The vast majority of Home Owners policies do have Replacement Cost on the building, which means you ARE entitled to recover the depreciation withheld, if you spent more than they paid you so far. You may also have Replacement Cost coverage on Contents depending on your Policy form and Endorsements.

Call your Insurance company as soon as possible regarding the additional payments for depreciation. Sometimes there is a deadline for making this request but I know it was extended many times for Katrina claims. Be prepared to document what's been done; receipts, photos, contractors invoices, etc.

Did the insurance companies estimate (including the depreciation) match the amounts you've spent on repairs so far? How has the entire experience gone? We've heard lots of horror stories and a few good ones.

We recently had some significant winds in our area. Our neighbors house lost a shutter, which came down on our Suburban, destroying the rear glass and mounts.
continues... Click
here

The neighbor has lost other shutters in the past for similar reasons - they do not appear to have been mounted correctly by the builder. the neighbor acknowledges the faulty installation, and the fact it's his shutters, but his insurance company is claiming 'Act of God', and will not pay. Our insurance will cover the damages, but I'll be out the deductable. Does this seem right? Shouldn't I be able to recoup the loss of the deductable?
Thanks...
Rob - Virginia
Answer:
Rob,
Yes, an "act of God" like strong winds will keep your neighbor and his insurance
company from having any liability for the damages. You are stuck with your own
auto policy coverage and it's Comprehensive deductible.

Since the past occurrences also involved winds you really can't do much. If
the shutters are truly installed incorrectly then the neighbor should get the
builder to correct or re-install them. I imagine the builder will blame "act of God" also.

In a very bad windstorm last week, my neighbor's pine tree fell into my yard. Who is responsible for the removal of the tree?
Lisa,
Ohiosee response Click
here

Answer:
Lisa,
Tree damage and neighbors continues to be our number one question. If you look at the bottom of our home page you can read similar questions, with answers.

Since the tree came down due to an act of nature, you are responsible for the tree cleanup in your yard, they are responsible for the portion in their yard.

Did the tree damage anything like your fence, a shed or a swing set? Anything besides the yard or landscaping? If something like that was damaged you could make a insurance claim and have some coverage for the damaged items as well as cleanup, otherwise there is no insurance coverage for the removal.
Good luck,
Scott - back

Hail damage to vehicles, required to repair?

Insurance company issued checks for the repair of hail damage to 3 of my vehicles. all of the checks where less than the estimates I got to fix the vehicles. If I would accept the lower amounts offered by the company I was not required to fix the vehicles. But if I wanted to be compensated for the actual cost to repair them I must get them repaired. Do I have to get them repaired or will they have to write me checks for the real amount that it will take to repair the vehicles? Do I have to get them repaired at all?
Tom,
Missourisee response Click
here

Answer:
Tom,
Why are the checks less than the repair estimates? I assume it is not just because of the deductibles?

Are they paying the actual cash value of the vehicles rather than the repair cost? This could be the case if the cost to repair is higher than the current value of the car.

If the payments are based on repair cost you might get several estimates and present them for additional payment.

The only time, I believe, you would HAVE to make repairs is if you have a lien on the vehicle. You would have to make repairs to protect their interest and their name would usually be on the check as well so you'd need their countersignature.
Good luck,
Scott - back

Vehicle damaged trees on our property, what is covered?

A vehicle had an accident on our property. We have to remove 2 trees as the result of the accident. We submitted an estimate to the insurance company(Nationwide) of the vehicle owner. Is there a limit on the reimbursement for our expenses or will the bill be paid in full?
Todd,
Pennsylvaniasee response Click
here

Answer:
Todd,
Talking about the vehicle driver's policy there should NOT be a limit since it is a liability claim. You should be able to claim the debris cleanup, removal of the trees, tree replacement and landscaping repairs if needed.

If the claim is on your property policy then there is a limit on tree replacement, usually a total limit and per tree limit.
Good luck,
Scott - back

Apartment
owner with fire, can I do the repairs myself ?

I live in Ohio and own an apartment building. I recently had a minor fire in the kitchen of one of the apartments. I got estimates for the repairs and the insurance company agreed on the figures. I was cut a check for the amount on the estimates. I'm an HVAC contractor by trade, not a building contractor, but none of the repairs required are beyond my capabilities. Do I have the legal right to do my own repairs and save myself the labor that would have been paid to another contractor, or is that considered fraud? If I have the right to perform my own repairs, does the insurance company have the right not to pay me for my labor? Any advice you can give me would be greatly appreciated.

Answer:
CN,
First of all, remember we are not lawyers so I can't answer the "legal right" aspect
of your question. I'll just tell you my views from experience in claims and general
insurance practices.

You have the right to have anyone you want do the repairs, including doing them
yourself. You are not supposed to "profit" from a claim, but labor is not considered
profit. After all you are taking time away from other jobs your business could
be doing.

Be sure to keep all the material receipts and labor records of the repairs and take photos to document the work was done.

Cleaning smoke damage and odor from adjacent areas is difficult so you may want to consider cleaning professionals for that portion of the repairs.

By the way did you lose any rental income because of the fire? You may have coverage for that as well.
Good luck,
Scott - back

Wind blew over 3 trees, agent said our coverage was limited to $500?

SRAIGHT LINE WINDS UPROOTED THREE LARGE TREES ON MY PROPERTY. NONE OF THE TREES HIT THE HOUSE, BUT ONE IS ACROSS THE ENTIRE DRIVEWAY , ANOTHER ON A WELLHOUSE AND PARTILALLY ON A NEIGHBORS FENCE, ONE LARGE LIMB ON TOP OF THE HOUSE. OUR INSURANCE AGENT CAME AND LOOKED AT THE DAMAGE AND SAID ALL OUR HOMEOWNERS POLICY WOULD PAY WAS $500.00. THE ESTIMATES WE HAVE RECEIVED SO FAR FOR CLEAN UP ARE OVER $1000.00. SHOULD THE TREE REMOVAL BE COVERED BY OUR POLICY? IF SO SHOULD THE TREE REMOVAL BE COVERED AT A HIGHER REIMBURSEMENT OR THE TOTAL TREE REMOVAL COST COMPLETELY COVERED.
THANK YOU,
HEATHER
Tennessee see response Click
here

Answer:
Heather,
First of all your agent is not an adjuster and should not be determining coverage or payment. Some companies let their agents take care of small claims and actually issue payment checks to speed things up but that is usually limited to food loss, emergency expenses or simple reimbursements.

This sounds like a situation where an adjuster should determine your coverage
and loss. There can be a conflict of interest with agents going any further as
they want to protect their "loss ratio" by reducing claim payments on their policies.

You should have more than $500 coverage available to you. $500 is the limit for removal off the premises of tree debris.

There is no limit (except reasonableness and your overall policy limit) to get the tree off the well house and to get the branch off the roof and, depending on your policy form, making the driveway accessible. Have your tree contractor separate the removal estimate into 2 totals - getting the trees off these items and then getting the tree debris off the premises.

Then, the repairs needed to the well house should also be covered. Has anyone checked the house roof? A large limb on the roof may have easily punctured, torn or just scraped shingles. This would require roof repair.

Does the fence belong to the neighbor entirely or is it a good neighbor fence? If you share it or co-own it the removal of the tree off your side and 50% of fence repair would also be covered.

OUR TRAMPOLINE BLEW AWAY DURING A STORM THIS EVENING. WHEN WE WENT TO LOOK FOR IT WE FOUND THAT IT HAD BEEN BLOWN ONTO A NEIGHBORS ROOF AND FELL DOWN OFF THE ROOF RIPPING SHINGLES AND TEARING UP THEIR GUTTERING. WHO IS RESPONSIBLE? WE HAD NO CONTROL OVER THE ACT OF NATURE.
JESSICA,
Indianasee response Click
here

Answer:
Jessica,
Your insurance should pay for the trampoline and any other damages (if any) on your property. Consider your deductible first though, it might not be worth filing a claim if there was nothing else damaged of yours.

Your neighbors insurance will take care of their roof, gutter and any other damages they had. If their insurance company thinks you are responsible they will try to collect their money back from your insurance company. The storm is an act of nature so you should NOT be found responsible, their only argument is maybe the trampoline should have been anchored.
Good luck,
Scott - back

Neighbors tree fell on our house who is responsible?

Neighbors tree fell onto our home causing roof damage and some limbs can through the roof into the attic - an alive tree 60ft pine. We had the same situation about 5 years ago from the same neighbor - who is responsible for the tree being removed, covering the roof with a tarp until it can be repaired? Everyone has insurance.
Wendy, -
Georgiasee response Click
here

Was there wind involved when the tree came down? I assume it was some type of weather event that caused it.

If there was no unusual weather and if the tree was rotten and if you had asked them to trim or remove it then your insurance company would still take care of you but they could try to collect their money (plus your deductible) back from the neighbors company. The fact that it happened 5 years ago may help but is really too long ago to matter much especially if there was wind both times.
Good luck,
Scott - back

Contractor with Question on Insurance Estimating

I am a small general contractor in Oregon new to home owner's insurance claims.

I have been asked to submit a written request for general contractor's overhead and profit from my customer's insurance company. I would like to know where I might find examples of such requests. Also where I might find appropriate percentages I should request.
Thanks,
John -
Oregonsee response Click
here

Answer:

John,
Generally insurance companies allow O&P on claims that involve 3 or more trades,
when you are coordinating the whole job. Sometimes they will allow it on any
job as long as a real General Contractor is involved.

There is no standard form that I am aware of, it is usually just included in the estimate. You might add a letter with a copy of your GC license #'s and Insurance certificates to show that you are a licensed GC.

Typically insurance companies allow 10% & 10% O&P. Not on top of each other,
10% each. So that a base job of $12,500 would have Overhead of $1,250 and Profit
of $1,250 or a job total of $15,000.

Most insurance companies use Xactimate estimating software, it has O&P items
in the database and uses insurance pricing and line items. That would make it
easier for them to read and compare your estimate to theirs.

You might want to check out our eBook the Claims Money Kit it will give you a lot of insight into insurance jobs and help with the terminology and procedures they use, things like depreciation holdback, dealing with mortgage companies, etc.
Good luck,
Scott
AskTheAdjuster - back

WIND DAMAGE

We had wind damage, why won't the insurance company replace our whole roof?

A little over a month ago I had a wind claim on my roof.
I have homeowners with xxx. The damage was to back side of roof and a dormer on the front side.
Xxx is wanting to pay for 1/2 a roof. They state there is no damage to front of home when there is clear damage to the roof on the dormer.
They also do not want to pay for a drip edge or debris removal. My policy states that wind damage is a covered peril and they will pay for a continuous roofing system between all walls.
How do they justify for only paying for 1/2 a roof? Now they have also agreed to pay for roof on 1/2 a dormer on front.
David,
West Virginiasee response Click
here

Answer:

David,
How old is your roof? Older roofs can be hard to repair as the shingles are brittle and it is hard to make a good transition between the old and new without causing further damage. Does your roofer think the roof is repairable?

The insurance policy does NOT cover matching, only damage. So they often want to replace only damaged sections of a roof.

Now that they have added 1/2 of the dormer does that make the replacement area over 50% or the total roof area? If so in some states they are required to replace the whole roof. Check with your State Dept. of Insurance, there is a link in the upper right of our home page.

Did your roof already have drip edge? They owe you to put the roof back to it's original condition so if you had drip edge they should pay for replacing it.

Debris removal is usually included as part of the roofing price in most insurance estimating programs (maybe they are including the drip edge as well). So you may not see it as a separate line item but it is covered.

The main thing is to compare their bottom line figure (before deductible) to your roofers figure. If they are lower then look for price differences or missing items. They should work with your roofer to agree on the repair costs.

Also, unless they change and decide to replace the whole roof you should not have any depreciation.
Good luck,
Scott
P.S. There are a lot of similar questions answered in our Free on line edition of the Claims Money Kit. The Deluxe edition is download able and has much more in it; Claim Money Kit - Deluxe.
Follow up Question:
I'm not sure how old the roof is, but there is 3 layers of shingles. The contractor does not think it can be repaired. I received a letter in the mail today that they will now pay for the drip edge and also debris removal. I'm very dis-satisified. Had I not threatened an insurance commissioner complaint, I don't think they would have paid. I did check with the Dept of Insurance, but in West Virginia they don't have to replace the whole roof even if they are replacing more than 50%. Any more suggestions?
Thanks,
David Follow up Answer:
David,
They should pay you to tear off all 3 layers and replace the felt, drip edge and other roof trims like flashings and roof vents. Get your contractor (or several roof contractors if possible) to write up a estimate(s) for what they feel should be done; replace the portion only or the whole roof and explain why if they feel the whole roof should be done. It can be hard to match a 3 layer section to a 1 layer section without leaking developing.
Then ask to speak to a senior adjuster or manager, now that they are giving in on some things push harder. It is unfortunate but lately it seems insurance companies deny first and concede later if pressed hoping that most people will give up and take what they get.

When the insured has a house fire, and have to temporarily move and has living expenses coverage,
is the contractor responsible for paying the insured's living expense overages when he has taken too long to complete the project and the living expense money has been
depleted? For example, rental furniture payments until completion of the job. continues... Click
here

Furthermore, if the same homeowner who had the fire, decides not to replace something exactly as it was, but instead decides to do something else with that money, and there is no money owed at the time, and no change order signed, can the contractor later (at the end of the job) come back and say that there is money now owed? For example, scope says $33 per yard carpet, insured choses $16 a yard carpet, and then uses a portion of remaining balance to upgrade kitchen countertops.

Is the Insurance Adjuster responsible for overseeing the contractor and that the job is done to the homeowner's satisfaction? Or, is the Adjuster to only write a scope of work to be done and to pay out the contractor draws? I would like a somewhat detailed description of what the adjuster is to do.

Thank you for your time. Once I've received answers to these questions, I will probably have more. I look forward to your response.
Stephanie -Missouri

Answer

Stephanie,
It sounds like some of these problems should have been dealt with earlier in the process but I'll give you some answers and hope it's not too late.

The ALE (Additional Living Expense) portion of your claim should have been based on projected time of repairs. Unless your maximum ALE coverage has already been paid you should be able to request a Supplement. Let your adjuster know as soon as possible that repairs are taking longer than anticipated. Your contractor will need to explain the delay and if it is reasonable the additional time should be covered. You may have a problem for asking too late or if the additional repairs like the granite counters are the cause of the delay.

Secondly, you are free to make changes as you do repairs, it is your home. The insurance company owes you the cost to return the home to pre-loss condition. Any alterations, improvements or changes are not part of the claim. If the
carpet was downgraded to upgrade the counters that should by okay, BUT you should have gotten something in writing from the contractor.

The insurance adjuster is not normally responsible for overseeing the contractor, that is really the homeowners job. The adjuster should have had an agreed repair price with your contractor and they should work together if anything (other than upgrades or changes) changed, such as costs or time of repair.

All these questions and more are answered in our eBook, Claims Money Kit.
Good luck,
Scott
AskTheAdjuster - back

Next
Door Tenants' Fire Damage

My family and I live in a single family residence very, very close to another
property that is owned by "slumlord" and rents out the two halfs. Well
Mr. high and mighty doesn't screen his residents very well as we consistantly
have trouble. Needless to say I am bitter about that whole situation so
I'll move on to the point. - continues Click
here

Our latest tenants did not have renters insurance but set their house on fire while we were out one day. The entire home, both halves, is condemned and hopefully for awhile : )

The fire started in the kitchen and at first they thought it was the gradma and the stove as she was home alone and not all there if you know what I mean. Now they are saying it was accidental and it was the floresent lighting in the kitchen that caught fire??

The damage to our house was the entire siding on that side of our house from the heat was melted away (not through the insulation) and a part of the roof on that side.

Turns out after all is said and done we are told to pay $1400 out of pocket after
our home owners insurance puts in part? How does this when it was not our fault
and it was this slumlords residence fall on us? shouldn't it all be on him and
his insurance company? I am very confused in all this. Please help.
Angela
Pennsylvania

ANSWER

Angela,
Where did the $1,400 figure come from? Is that your deductible? Do you know if you have Replacement Cost Coverage on your policy?

$1,400 seems like an odd amount for a deductible, they are usually $500, $1,000, etc. So I suspect that some of it is depreciation which you should get back when repairs are made (most Homeowner polices are Replacement Cost on the home).

Your insurance should pay for replacing the siding and any related trim items (window wraps, soffit, fascia) on that side of the house. What kind of siding is it? Will the other sides of the home look okay? Insurance policies don't cover matching but some states force them to do the whole house if a reasonable match can't be made with the other siding.

They should also replace the damaged slope of the roof, the entire slope. Have a roofer look at it and make sure repairs can be done. The debris removal of any damaged items on your property would also be covered.

Your insurance company would attempt to recover (or subrogate) their money from the owner of the neighboring house (or the owners insurance company) if the fire could be considered due to negligence, or someone found liable. They would also try to recover your deductible if this was the case and eventually reimburse you for that. If it was caused by wiring it is very unlikely that any liability could be established so you are probably out of luck there.

If you want to provide any more details I will be glad to respond again.
Good luck,
Scott
AskTheAdjuster.com - back

Hail Damage

I have a question regarding, if i was traveling within my state and experienced hail damage to my car to an extreme extent and have a comprehensive coverage with a deductible of 500. what will the questions be and paper work required to file a claim and use this protection. ive searched the companies web site and found no info to specify, and will it increase my rate for using this option?
Kyle
Missouri- see response Click
here

ANSWER

Kyle,
Hail damage to your car is covered by your Comprehensive Auto policy. I would go ahead and call in the claim to the claims line or your agent.

They will want to know where and when the damage happened, especially since you were traveling and there may not have been any hail near your home. They will verify there was hail in the area and date you report. That should be the only question regarding coverage.

I would go ahead and get an estimate from your dealer's body shop. Depending on the age and value of your car it could even be considered totaled. The insurance company may make their own estimate as well but it's always good to get your own.

I can't answer the question about your rates going up. Generally a comprehensive claim, especially for a weather event like hail, should not affect rates. You can ask your agent, they should have a better idea on the effect of this type of claim.
Good luck,
Scott
AskTheAdjuster.com- back

Roof Damage Estimate

We have roof damage,(32 squares total roof) the adjuster estimated 15 squares to be replaced, that's about half of our roof, divided in three seperate sections.
- ..continues
Click here

He estimated $2,400. Bids received for new roof is $5,000. My ? is why don't they pay for the whole roof, I don't want my roof to look like a patch worked quilt to only do half, I can't afford to have the whole thing done. I do understand there is depreciation and my deductable.
Judy
OklahomaANSWER

Judy,
The deductible would be the only amount subtracted. The depreciation should not matter, most Homeowners policies cover Replacement Cost for the roof. If they replace the whole roof, they may withhold the depreciation until the work is done but you should get it back. If they persist in only repairing the roof they should not depreciate at all.

How many total sections are there on your roof? Are there other "slopes" or
sections (adjacent to the 3 sections) that are visible from the street? If so
you can argue that the roof will look awful and devalue the home. Insurance polices
do not cover matching, only damage, but most companies will replace adjacent
slopes visible from the same angle.

Does your roofer believe the roof can be partially replaced? You might ask for a re-inspection from the insurance company. Usually if the roof is over 50% damaged they will replace the whole thing, yours is pretty close.
Let us know if you have any further questions.
Good luck,
Scott
AskTheAdjuster .com - back

An Agent asks about a "Good neighbor" fence

I've always been told that when a fence blows down between two neighbors, say
in a storm, that the claim is settled by the "good neighbor doctrine" and
only half of the homeowner's property loss deductible is applied. Is this
right?
Denise - Insurance Agent
California - ..see
response Click
here

ANSWER

Denise,
I believe that is, or was, a common practice but not written into any policy I know of. It is up to the companies involved.

If there is no other damage only the fence and if the fence is jointly owned/shared; then each policy would be responsible for 50% of the damage. Since they are only paying for 50% of the repairs, 50% of the deductible makes sense.

The Insurance company might argue that they are paying 100% of your damage (since you only own 50% of the fence) and then want to apply 100% of your deductible.

Remember also that a fence is not eligible for Replacement Cost coverage if the
entire thing is being replaced. Some companies will depreciate replacement of
1 "run" of the fence, others will call this a repair and not depreciate.

Who is responsible to clean up neighbor's blown
down tree from my yard?

If a neighbors tree falls in your yard during a windstorm, whose responsibility is the cleanup?
DK
Washington..see
response Click
here

ANSWER

DK,
Sorry DK, but the cleanup is generally the responsibility of each property owner. It doesn't matter who's tree it was, you would take care of your yard cleanup and your neighbor theirs.

Did the tree damage anything? Like a building, fence, swing set or anything beside landscaping? Or is the tree blocking your driveway or access to your home? If so your insurance policy may help with the cleanup.

See the Q&A's on the lower portion of our home page; trees and the damage they
cause is our number 1 asked question by far.

Good luck,
Scott
P.S. Be sure to check your roof for damage, if the wind was strong enough to take trees down you may lose shingles as well. -
back

Why is the insurance company keeping the depreciation
on my contents?

Hi;
My catastrophic claims adjuster just informed me that contents will be figured on a depreciated basis until AFTER I replace the item, and then, I have to submit a receipt to get the rest of the replacement coverage....continues Click
here

This means I have to have the finances available to go out and get replacement items prior to getting money from the insurance company.

I didn't buy replacement item insurance but rather, replacement coverage. Is there a way for me to fight this battle with xxx Insurance? Thanks for your help.
M
Missouri

ANSWER

M,
That is the way the policy is written, some companies waive this and pay the full Replacement Cost (RCV) payment up front. There really is no way to fight it unfortunately since it is part of you contract (policy) with the insurance company.

You can replace the items incrementally; that is replace a few of the most important items, send in your receipts and get the additional money, then replace more items. Ask the adjuster what time frame you have for the replacement, it should be 1 year from the date of your loss, or your settlement.

Also look at the depreciation percentages on the estimate, you should have an itemized estimate showing you all the items paid for and the RCV, depreciation and payment (ACV) for each item. If the percentage of depreciation seems too high you could request more money up front.

Depreciation is supposed to be based on age, condition and life expectancy of each item individually. Catastrophe adjusters are always in a hurry and sometimes just slap on general percentages.

If you are still working with the original adjuster ask him/her to reconsider the depreciation. You will be working with a desk adjuster at some point to claim the additional payments, you can work with them also to reduce the depreciation if the original adjuster is no longer available.

We had a bad fire that started in our garage in Dec. There was a lot of smoke and soot damage. Would it be best that we replaced our mattresses, because we have 3 children with Asthma?
SW
Texas -see response Click
here

ANSWER

SW,
I would have the home and contents, especially all the "soft" furnishings and
building items, evaluated by cleaning professionals. The soft items include anything
with cloth or other porous material such as; mattresses, couches, chairs, drapes,
bedding, clothing and carpeting.

You need a fire restoration type company that has the proper training and equipment. They will be able to tell you what items are cleanable and what needs to be replaced. With your children's asthma conditions this is especially important. Let the contractor know about their condition as it may even effect the chemicals and processes they use in cleaning.

I hope you have insurance on the home and contents. The cleaning costs can be large and you will be surprised how many things will have to be replaced due to odor and soot.

We have a free on line book with lots of information on claims and contractor dealings; Claims Money Kit that may help.

My neighbors tree fell on my house, placing a large hole in the roof and
siding. I was out of town, unaware of the issue. My neighbor states he was
unable to get anyone to remove the portion of the tree resting on my house,
he stated no company would take the job. Accordingly, nothing was done to
cover the hole and "protect the property from further loss". ...continues Click
here

The tree fell when it was windy. Not sure how healthy the tree was and if there are any other implications in regard to that.

We had quite a bit of rain, causing damage everywhere. I can't imagine the insurance implications, I think I should be calling a lawyer.
Please help,
John
New York

ANSWER

John,
First, unless you were out of town for months, that does not matter. It would have been nice of your neighbor to reach you and let you know what happened. I can understand that tree removal companies would not want to work on your premises without any authorization from the property owner.

Protecting the property from further loss is a policy requirement but you can't do that until you are aware of the damage. As long as you take steps now to limit further damage you should be fine. Get the hole covered to prevent further water intrusion, water is the biggest problem in these type of claims. You are authorized (required even) by your policy to make temporary/emergency repairs. Be sure to keep all receipts and take some photos first, and during, digital if possible.

The fact that it was the neighbors tree does not matter, your insurance policy should respond to the damages. I don't see that you would need a lawyer, just call in the claim to your company. You can always get a lawyer or Public Adjuster latter if needed.

You should also start to get repair estimates, you need someone to do the work anyway and the sooner you get estimates the better. This will help your claim negotiations with the adjuster as well.

Get the hole covered and the water dry out started as soon as possible you don't want to let moisture problems develop.

You can find more free information in our on line eBook; Claims Money Kit.

Let me know if any further questions or problems come up during the claim.

Hi there! I know most of the questions on your site are about trees, so I thought I ask you another one.
My neighbor came over and told me my trees and their branches "made her nervous". I tried to be a good neighbor and spent $2,000 on cutting down one tree and doing serious trimming on the others. The tree guys cut away anything that looked dead
or diseased....continues Click here

So this morning my neighbor came over and told me a branch from one of trees put a hole in her roof! The tree branch is still in her roof and it went through the roof but on the outside. I do not think the interior of her house was affected but I do not know for sure. Here is the obvious question, who is responsible? I cannot tell if the branch was diseased because I haven't looked at it. But I just had all the diseased and dead parts of the trees removed. I tried to do the right thing earlier for her. Also, the tree guys said she is able to cut whatever she wants to off my trees as long as they are on her property. I told her that as well. This is so upsetting. Please let me know what you think! Thank you very kindly!!!
AU
Florida -

ANSWER

AU,
Was there any wind or weather event around the time the tree limb fell? The
right weather can cause any tree to come down, or lose limbs, and it is considered
an "act of God" with no liability to the tree owner.

Is it possible the tree trimmer left a limb dangling or even cut off but caught in other branches? If so, the tree companies liability policy may provide coverage. This doesn't seem likely as I imagine you or your neighbor would have noticed.

It sounds like you took all the precautions you could have. The normal procedure is to let your neighbor's insurance company handle her damage and repairs under her policy. They will notify you and your insurance company if they feel they can "subrogate", which means collect their repair costs back from your insurance
policy.

Make sure to keep all your documentation from the tree work, when it was done, how much was trimmed and anything else you can document. It sounds like you did more than most neighbors would have. Many people won't cut or trim their trees unless they are really pressured by a city or county type body.

Good luck, let us know how it works out,
Scott
AskTheAdjuster.com-------back

Tree damages from ice, coverage for removal?

Recent ice storm has damaged many trees in Tulsa. My policy provides
for up to $1000 coverage for removal of fallen trees due to weight of
ice....There are several fairly large (2 and 3 inch caliper) limbs that
have broken and are just hanging by a "thread" or are just resting on lower branches waiting to fall to the ground.
- continues -
Click
here

Policy also provides for debris removal.

My question is does the removal of the hanging tree limbs fall within the fallen tree coverage. Estimates so far are between $750 and $1000.

Thanks in advance for your assistance.
MG -Oklahoma Answer:

MG,
The standard policy does provide $1,000 coverage for the removal of trees felled by ice, BUT only if the trees damaged a covered structure or block access. I pasted a section of the typical HO policy below, note the
conditions 3 & 4 that have to apply to get the coverage.

If your only damage is the dangling limbs then it sounds like you would be out of luck. The Debris Removal coverage also has conditions that would prevent coverage in this situation.

If you do have other damages or any other information to add let me know and I'll reconsider the answer.
Good luck,
Scott -
AskTheAdjuster.com--back

Condo water damaged from neighbor's unit

Living in a condo I own. Neighbors pipe froze and burst last year flooding my home. It ruined all the floors and some wall damage We both have the same insurance and both had
to pay the deductable before they paid $750 each.continues -
Click here

This week. A pipe in her unit either froze or became disconnected under the sink and flooded my unit again (same source area as before). The agent will not be clear on the cause. He again stated we both have to pay our
deductable before they pay. $750 each. Why do I have to keep forking out money for damage caused by her unit. If it froze again, she knew it was possible and should have opened the cabinet or left the water
dripping.

If the pipe became disconnected she should have taken care of general maintance in her unit to prevent this. Why do I have to pay if she was negligent? What can I do?
MG
Kentucky -

Answer
MG,
Condo coverages are very complex and different in every state. I'll try to give you some general advice and things to look for, feel free to send additional information and I'll try to help more.

First, I would review the Condo Association Declarations & By-Laws, look for
the property insurance and maintenance sections. This should spell out the insurance
responsibilities and requirements for the Association and
the Unit Owners. If you do not have a copy of the Declarations ask your Condo
Association President or Secretary for it, they should have been given to you
when you bought the unit. You might check to see if there have
been any Addendums or Revisions also.

In many states the Association is responsible for the interior of the units as well as the common areas with the Unit Owner's insurance responsible for only owner added improvements and contents.

Has the Condo Master Policy been involved or just your Unit Owner's policy and the neighbors Unit Owner's policy?

Normally I would think the loss would go under the other unit owners policy and/or the Master policy. Typically your insurance company would take care of your damages and go after the neighbor's insurance company
afterwards to recover their money, including your deductible to reimburse to you. It should not matter, only make is simpler, that they are the same company.

Have you spoken to an adjuster or just the "agent"? An agent is the one you buy insurance policies from, they are usually not involved with claims at all
except for reporting them initially. Ask to speak to a claims supervisor or manager and ask them to clarify coverage responsibilities. They should spell out clearly the Condo Master policy responsibilities, the Condo
Unit Owners coverages and the liability factor of your neighbor.

If you don't get cooperation and good help from the adjuster call the KY Dept. of Insurance, their web site is; http://doi.ppr.ky.gov/kentucky/ and phone 800-595-6053. They can give you some advice based on the State
Insurance regulations for Condo insurance and/or you can file a complaint if necessary.

Good luck & let us know how it works out,
Scott -
AskTheAdjuster.com-------back

Roofing company question on insurance estimate

I work for a roofing company and I am trying to figure out when I can charge O & P to our customers. I think the way that it works is that if a we
do all the work on the insurance paperwork and the customer signed for what insurance allows we can charge the entire O & P. But, if we don't do all the work on the insurance paperwork then we can only charge O & P for
the work that was performed. Example: Customer has roof replacement, siding, and gutters. We only do the roof, so therefore we can only collect the amount of O & P that pertained to the roof. If we did all three items,
then we can collect all of the O & P.
CB,
Texas - see response -
Click
here

Answer:
CB,
Insurance estimates usually include O&P if there are 3 or more trades involved or if a General Contractor is being used.

Roofing is generally considered to have the O&P already built in to the roofing prices and in fact some insurance companies I have worked for make us exclude all roofing items from O&P even if we have 3 trades
involved

If you co-ordinate all the work as a General Contractor then you should be entitled to charge the whole amount. If you only do the roof work then usually you would not be allowed the O&P payment (or portion) in addition.

Let me know if you have any additional questions. There is a lot of information pertaining to claims payments, contractor relations, etc. that might help you in our eBook, check out the Free version here:
http://www.freebook.asktheadjuster.com.
Thanks,
Scott-------
back

Can my Insurance Company
force me to use "their" contractor?

I was involved in the So Cal fires. My insurance company, "xxxx" made me use a "fire clean up expert" general contractor. They damaged roof tiles, water damage to the ceiling, poor work on the patio cover. Now the
insurance company is forcing me to use them for sprinkler and plant replacement and wont let me use my subs for window replacement which I used to purchase same windows last summer. The landscaping and stamped concrete was also replaced last summer and I want to use now. I also want to get someone to replace the rain gutters but they keep passing on everyone saying too expensive. I can't use anyone else except their contactor. I actually had to get three opionions that the trees in the back
yard are dead. Does this sound correct? Or am I getting taken? And yes I am a single female if that matter, and was too willing to work with everyone.
NG
Californiasee response -
Click
here

Answer:

NG,
It does sound like they are taking advantage of you. The insurance
company cannot require you to use any specific contractor. See the
following excerpt from the CA Fair Claims Practices Regulations;

Section 2695.9---(b) No insurer shall require that the insured have
the property
repaired by a specific individual or entity. ---(c) No insurer shall suggest or recommend that the
insured have
the property repaired by a specific individual or entity unless: --------(1) the referral is expressly requested
by the claimant; or --------(2) the claimant has been informed
in writing of the right to select
a repair individual or entity and the insurer shall cause the damaged
property to be restored to no less than its condition prior to the loss and
repaired in a manner which meets accepted trade standards for good and
workmanlike construction at no additional cost to the claimant other than
as stated in the policy or as otherwise allowed by these regulations.

Tell them you know your rights under the California Fair Claims Practices
Regulation and will call the CA Dept of Insurance if needed to complain.
Their # is 800-927-4357 or http://www.insurance.ca.gov/.

You should also check that the company they made you use is licensed,
check with the Contractors State License Board www.cslb.ca.gov or call at
800-321-2752.

Any damage they caused or unacceptable work they did should be
covered/corrected as part of the original claim.

Did they give you an itemized estimate from their adjuster? What basis are
they using to say your person is too expensive?

They can negotiate with your contractor if they believe the price is too
high, but they cannot refuse to let you use whoever you want. If they can
establish that your contractor is charging above a reasonable market rate
then you should still have the option of using him and paying the
difference.

You may need to start dealing with a manger or supervisor if the adjuster
you have been working with is not more helpful. Generally they are after
threatening to involve the Insurance Commissioner!

I see you purchased our Claims Money Kit eBook already, thank you!
Check the chapters on Additional Damages and Supplements. The CA state
web site (link above) also has a lot of helpful information and links you
might check out.

If you have any additional questions, please email me direct and I'll help
out as much as I can.
Thanks,
Scott
AskTheAdjuster.com

Followup
Scott,
Thank you for your advice. I requested an itemized scope of work from
both the general contractor and the adjuster and never received anything.
I've been living with broken windows in the house. In order to get them
ordered, I had to pay out the money and then request reimbursement from
the general contractor. The only way I found out that the general
contractor had the money was the window guy called the insurance agent
who told them that they were funding all the money to the general
contractor as soon as the claim was approved. So I don't even know what
was approved or how much they got paid and for what work. To date, all
they did was work on the patio cover which was deficient but at no time
was I ever asked if it was to my satisifaction.

In fact, I had to provide a list of items to the contractor and the insurance
adjuster to make sure we were all on the same page as to what needed to
be repaired. I have been keeping track of dates, etc. The rain gutters they
kept ignoring and the roof inspection and the water damage in the kitchen
due to the power washers. The sub contractor who they finally brought out
to bid on the rain gutters last week, was in fact the general contractor's
brother, and I'm not sure who decided he was too expensive but I never
saw the quote. I have never seen any dollars for any of the work
performed except for the things I am paying for out of pocket.

Since reading your book I have sent a letter to the insurance company
directly asking them for a settlement estimate and will call the insurance
commissioner's office next week on how to proceed with this. Your book is
a valuable tool and I appreciate your help.
Thanks,
NG

NG,
You need to take steps to stop the Insurance company from paying the
contractor direct. This sounds completely unethical to me, but I can't find
any reference to this practice in the CA Fair Claims Regulations, so far.
The claims payments should ALL come directly to you. If you have a
mortgage holder their name may be on the check as well but that's okay. If
you have a contractor doing all the work their name can also be on the
check but it should still come to you and have your name on it. This is the
only way you have any control or leverage over the contractor and the
quality or completeness of the repairs.

Here's another excerpt from the CA Fair Claims Practices Regulations;
Section 2695.9
(d) If losses are settled on the basis of a written scope and/or
estimate prepared by or for the insurer, the insurer shall supply the
claimant with a copy of each document upon which the settlement is
based. The estimate prepared by or for the insurer shall be in accordance
with applicable policy provisions, of an amount which will restore the
damaged property to no less than its condition prior to the loss and which
will allow for repairs to be made in a manner which meets accepted trade
standards for good and workmanlike construction. The insurer shall take
reasonable steps to verify that the repair or rebuilding costs utilized by the
insurer or its claims agents are accurate and representative of costs in the
local market area. If the claimant subsequently contends, based upon a
written estimate which he or she obtains, that necessary repairs will
exceed the written estimate prepared by or for the insurer, the insurer
shall:
(1) pay the difference between its written estimate and
a higher estimate obtained by the claimant; or,
(2) if requested by the claimant, promptly provide the
claimant with the name of at least one repair individual or entity that will
make the repairs for the amount of the written estimate. The insurer shall
cause the damaged property to be restored to no less than its condition
prior to the loss and which will allow for repairs in a manner which meets
accepted trade standards for good and workmanlike construction at no
additional cost to the claimant other than as stated in the policy or as
otherwise allowed by these regulations; or,
(3) reasonably adjust any written estimates prepared by the
repair individual or entity of the insured's choice and provide a copy of the
adjusted estimate to the claimant.

I would call the CA Ins. Dept on Monday to see if they'll help you get the
direct payments to the contractor stopped. This is especially bad since you
don't even know what they are figuring for your damage claim.

I would also get written estimates from your prior contractors, or a General
Contractors estimate for all repairs, and present it to your insurance
company for payment. See Section 2695.9 quoted above, they are required
to respond.

You really want to get an independent opinion on the roof damages and
leak their contractor may have caused. Don't let the water damage go too
long or you'll have new problems.

Make sure you continue to make notes and document all calls,
conversations, etc with the insurance company, agent, adjuster and all
contractors involved. Also keep copies of everything you send or give
them.

Hope this helps, let me know what develops or if you have any other
questions.
Scott------- go
back

Neighbors' Tree

My neighbors tree fell on my shed going right through the roof
damaging some contents in the shed. Should I contact my homeowners
insurance policy.
MC,
From New Jersey -
see response -
Click
here

ANSWER

MC,
First, it does NOT matter who's tree it was, damage to your property
is covered by your policy, the neighbors damage, if any, is covered
by their policy.

Check your policy declaration page first to see what your deductible
is, make sure there is enough damage to justify a claim. If you have
a high deductible and the damage isn't that much over it then you
might consider not making a claim at all.

If the tree was obviously rotten or appeared dangerous prior to
falling then your insurance company might be able to collect from the
neighbor's insurance company but they would take care of your claim
first. This is usually difficult to prove after the fact.

Hopefully you have Replacement Cost Coverage on your contents as well
as the shed. Make sure to list everything out there and take photos.

The policy should cover; tree removal off the shed, a limited amount
(usually $500) toward tree removal off the premises, repair or
replacement of the shed, replacement of the contents and removal of
the debris.

There is a lot more information in our
Free on line book, try this link
http://freebook.asktheadjuster.com/ Let us know how it works out.

A tree limb fell on my car at my company's
parking lot. The tree was live, however, the limb broke at a point where there
was definite
rot. I do not have comprehensive auto insurance, however, I filed a claim
for the repairs with my employer's commercial business owners policy
with umbrella coverage.continue - Click here

When I first reported the claim to ins co,
they asked whether the tree was alive. I told them no. They are now
refusing to pay for my damages stating that I told them the tree was
in perfect health. I sent pictures of the limb and I saved the limb.
The insurance company has ignored the photos and will not even look
at the branch I saved. They claim they are denying solely on the
basis that I told them the tree was alive. My car was parked on the
company's property and the tree was also. Any advice for disputing
this claim? I only want my car fixed.
Thank you

RBFrom New Jersey

Answer

RB,
The majority of our questions have been about trees and tree limbs so far.

If your company does not own the building and/or parking lot there
may be another policy (insurance company) you could pursue. I assume
your company does own it though or they would not have even responded
to your claim.

Did anyone ever notice or complain about the tree being
hazardous/dangerous prior to this accident? Ask around, if the tree
or any of it's branches looked like they might come down maybe
someone complained. If so this would help your case immensely.

Generally a live tree limb breaking is considered an "Act of God" and
the parking lot owner's insurance would not be liable. Your auto's
comprehensive policy (if you had the coverage) would have paid for
your damages and a rental car if needed less your deductible.

Probably your only option is to complain louder to the insurance
company and hope they reconsider. Ask to speak to a manger or
supervisor, offer to email the photos to them. If you can make it
more trouble to deny you than to pay you maybe you'll get some action.

A parked car reversed out of her parking and hit my car, who is
responsible to pay the damage.
AK
From New Yorksee response -
Click here

AnswerAK,

With auto claims it is best to call your insurance company and let them sort it out. They should take care of your car damage, and a rental car if needed, and then pursue the other drivers insurance
company if they feel that driver was at fault and depending on your state's fault laws.

Recently a tree in my yard was struck by lightning and is showing signs that is could be at the end of its life. Is the removal
of this tree covered under standard home owners policy?Its a large hardwood and I expect that removing it will exceed my deductible.
Thanks,
PD
Georgiasee response-
Click here

ANSWER

PD,
The coverage for this can vary by company and state so check your individual
policy. In the standard Home Owners policy it is Section E. Additional
Coverages, Item 3 Trees, Shrubs and Other Plants.

This covers trees for damage by lightning, typically up to $500 for any
1 tree. The deductible should not matter since any grown tree is worth
well over $500, your deductible would be absorbed by the excess loss.

This should give you $500 toward the tree removal at least. Unfortunately,
for the Debris Removal coverage (also under Additional Coverages, item 1 b.)
the tree has to damage covered property before any removal expense is covered.
Good luck,
AskTheAdjusterback

Damage to my auto, whos' at fault?

I just recently got into an accident and would like to find out who the insurance would find at fault. It is not clearly discernible if I am at fault or the other person. Continues -Click
here

The accident happened tonight about 2 hours ago (830 pm PST).
I was backing out of my driveway to turn left. My house sits on a street
that run east and west. I was backing
out turning my car to go west. My next door neighbors car was parked along the
curb but not clear of my path. In other words, the back of her car was sticking
into my driveway
path. You know that part of the sidewalk that slopes down as it meets the driveway?
Well, her rear tire was at that point so the rest of her car (a small 4 door
Saturn sedan) was
sticking into my driveway path. I have 2 cars, one that I park on the left in
the garage (the car I was driving) and the other I park on the driveway on
the right side of the
driveway (not in the garage). Due to my other car parked on the right side of
my driveway and this car that is impeding my path, I have limited room to
back out. Since I'm turning
left as I back out, my car hits the illegally parked car. My front driver side
fender & driver door hit the corner of her bumper on the right side of her
car. There is considerable damage to my car (fender and door dented in with
scratches all over).
I couldn't tell if there was any damage to her car, not that I looked (because
I was certain it was her fault). Her friends and her looked and couldn't
see any damage.

I initially thought it would be her fault since its her car that was illegally parked.
I wouldn't have hit her car if it wasn't sticking into my driveway path limiting my
space to back out to the left. But after talking to a friend , I'm starting to think
otherwise. My friend mentioned that, had I looked back while I was reversing out, I
probably would have seen the car and could have asked someone to move it. His point
was that just because the car was illegally parked doesn't mean I have to hit it.

So my question is: Is it my fault for not looking back while I reversed or is it her
fault for illegally parking and impeding my path? Keep in mind, that I have another
car parked on the driveway that limits the room I have to back out to the left.
Thanks!
SS,
From California

ANSWER

Dear SS,
In a "no-fault" state each auto owners insurance would pay for their own damages.
I don't believe CA is a no fault state though. You and your neighbor need to
trade
insurance information and each turn in claims to your own insurance company and
let
them sort it out.

Sorry, but I would think her improper, or illegal, parking was a less serious
violation than your backing into her car.
Good luck,
AskTheAdjuster - back

My car was damaged in parking lot, should the
contractor pay?

Submitted: September 16, 2007My car was damaged at my apartment complex by a outside contractor
hired by the apartment managment to replace a fence that was close to my car.
While they were
replacing it a part of the fence hit my car hood.More ....-Click here

* RESULTS

The two estimates for the damage were $500+ and for awhile I was getting a run around. I then reported it to theproperty managment and she told me this contractor has insurance,and if he doesn't pay for the car damage, he will not get paid for replacing the fence.

My question is if the cost of fence repair is less then my car damage, who will pay for the remainder, contractor, apartment managment or if all else fail, my insurance
company? ( $500 deductible )
JC,
From Indiana

ANSWER

Dear JC,
Since the contractor has insurance that should be your first option. Notify the
contractor (verbally and follow up in writing) that you have damage and need his
insurance information. Ask him to present the claim and give you the policy and
contact information for his insurance company and adjuster. The contractors liability
coverage company should work with you to get the car repaired, with no deductible to
you. If the car has to be in the shop for repairs you should also claim a rental car,
if you need it.

It sounds like your apartment manager may have the contractors insurance information.
You could contact them directly to submit a claim if the contractor doesn't sound like
he will.

If the contractor refuses, and you can't reach them yourself, advise him you will be
claiming the damage on your auto policy and your insurance company will then be coming
after him and his insurance company for reimbursement. This should get him moving in
the right direction. A insurance company can be more threatening than an individual.
Good luck,
AskTheAdjuster
PS If you do have to go through your insurance, they should recover, and pay you back,
your deductible as well.

RESULTS
-
Hi, I just received a check in the mail for my car damage, Thanks to my apartment property management for hanging in there and
refusing to pay the contractor. - back

I have major damage from trees falling, what is covered?

I am getting conflicting information from your
web site and my HO policy. I'll try to spell out my issue here. I suffered a sizeable loss during a tornado about 2 weeks ago. The largest expense will be
(was) the removal of the downed trees from my property. There seems to be different interpretations about how and if tree removal is handled.
The common theme seems to be that if the tree has fallen on "covered property" the cost to remove the tree from the covered property
only would be picked up by the standard ISO homeowners policy. The cost to remove it/chip it/ take it away would not be a covered expense. continues -
Click here

I am trying to determine if my Homeowners policy is a "standard ISO policy" and if the wording would afford this coverage, or if their form has been modified to limit it. The only place I can find it somewhat addressed is under ADDITIONAL COVERAGES - Debris Removal. The policy states: "We will pay your reasonable expense for the removal of: a. Debris of covered property if a Peril Insured Against that applies to the damaged property casues the loss; or....." (Further to that, the policy applies a separate coverage to trees up to $500.00 total for all trees)

In my situation- numerous trees had fallen on my "covered property", including 4 trees on a boat trailer, 3 on a boathouse, 3 on my barn, numerous on my driveway, as well as several on picnic tables, a canoe, playhouse etc. (It was a real mess!)

You can see my concern. The tree removal company walked the property over both
before and after cleanup and gave an estimate to me for both the cost to "remove the trees from my covered structures" and the cost to "remove the trees from my property".

Can you give me an interpretation on this and/or advise if this is the standard
ISO HO policy or where I might find that out? In my research, most sources I've
found state that the "standard ISO HO policy" would respond for the removal from
the structure only- but at least there is some coverage.

Thank you in advance
BT
From Vermont

ANSWER
Dear BT,
Has a adjuster been out and given you their interpretation yet or are you trying
to decide if you will even file a claim?

I believe the "Additional Coverage-Debris Removal" section will give you the
$500 coverage toward removal of the trees from the "premises". (If you are
quoting that section from your own policy, some states and some companies have
different limits for that coverage.)

Typically insurance companies cover the reasonable cost to get trees off covered
structures as part of the inspection and repair process. (You cannot repair a
roof until you remove the tree from it.) If the boathouse, barn and playhouse
belong to you then removal of the trees off of them should be covered. This
means just getting them off the structures and clearing enough space to access
and repair the structure. The removal off the property, chipping, stump
grinding etc. is where the $500 coverage applies.

The above should apply to the picnic tables as well assuming you have Contents coverage.
The boat trailer and canoe may be different as policies limit coverage for watercraft
and their equipment.

The driveway may be treated the same as the structures (especially if it is damaged in anyway) and sometimes removal is covered due to access to the premises.

Sounds like the tree removal company is familiar with insurance claims. Anyone that gives you 2 estimates as you stated has worked with insurance before. Hopefully
their "remove from covered structures" estimate is the majority of the full cost and will be covered.

Good luck and let us know how it works out or if you have any other questions.
AskTheAdjuster -
back

Our tree fell on the neighbors house, whos' insurance should pay?

Story: Our tree fell in the neighbors yard knocking out the power to the house,
and damaging the fence. We didn't know we wern't responsible for getting the power
back on, so since it was our tree we the called an electrician. We found out we were
not responsible and the neighbor says his insurance company says it's our
responsibility to pay the electrical bill.

Question: are we responsible for the bill since we made the call? What can we
do regarding getting him to file the claim?
SB
From Kentucky -
see
response - Click
here

ANSWERDear SB,
What caused the tree to fall? Was there a thunderstorm, lightning,
strong winds, was the ground saturated from rain? Or was the tree
noticeably rotten, leaning or appear dangerous prior to falling?

Who does the fence belong to? You, your neighbor or shared?

If the fence is yours or half yours:
Your policy should pay for getting the tree off the fence
(just enough to access and repair the fence), repairing (or
replacing) the fence and probably $500 for getting the tree
debris off your property (check your policy under "Additional Coverage - Debris Removal" some polices have more).

If the fence is the neighbors or half theirs:
Their policy should do the same as above plus the electric repairs.

The electric repair may fall below the neighbors deductible so they
don't want to file a claim. Their policy should be the one to
respond on the electric bill, it would not be covered by your
policy. Unless, the tree was rotten, but even then, their insurance
company should respond then try to collect from you or your insurance
company as a liability claim.

If you can't get any cooperation from your neighbor you may be stuck
with the electric repair bill. I'm sure the electrician wants to be
paid and it sounds like you essentially contracted the job.
Good luck,
AskTheAdjuster

P.S. If the fence or other damaged property is yours, you want to
consider the repair cost before deciding to file a claim.
See our free insurance guide (there's a link on the home page of
AskTheAdjuster.com) and check the CLUE report chapter, you don't
want to file too many claims!

* * * *

Follow up from SB
Thank, you so much for your response. The tree fell due to wind. Our
insurance company paid a % to have the tree removed. The neighbor
insist on stating his insurance company states it's our responsibility
to pay for all of it becasue it was our tree. I'm sure you are right
regarding our now not so neighborly neighbor. He doesn't want to file
a claim because his deductible is $1000.00 and the electrical is
$1400.00. Yes we contracted the job and will most likely be stuck
with the bill. After all it's not the electrician's fault.

I'm wondering if we can sue him for the amount of the bill. Do you know
anything about that?
Thanks again,
SB

ANSWER to
'follow up'Dear SB,
If wind was involved that's considered an "act of god" and there is no
liability on your part, in other words it does not matter who's tree it
was. Each homeowners insurance should respond to the damages on their own
insured property only.

Regarding suing the neighbor, we can't (and aren't qualified to) give legal
advice. Seems like that amount would qualify for small claims court? I guess
the relations with the neighbor can't get any worse at this point so it wouldn't
hurt to try to recover your money.
Good luck,
AskTheAdjuster - back

I have received an insurance check for hail damage, how do I get the rest of the money?

I recently submitted a claim for hail damage. The adjuster came and made up his
list of repairs, and issued a check for the ACV part of the claim. The depreciation
value was held back till work is done.

My question is: Am I required to perform all
the repairs on his list, and how does it affect the claim funds if I don't? Also
can I make some repairs myself and how does that affect the funding?
SP,
From Pennsylvania - see
response -Click here

ANSWER

Dear SP,
The adjusters estimate should detail the items that were depreciated. Look for
columns like RCV (Replacement Cost Value), Depr or Deprec, and ACV (Actual Cash
Value). The only items that should be depreciated are things that are considered
improvements or betterments such as the shingles. They should not depreciate tear
off/removal, debris hauling or any other labor items.

Generally you are not required to complete all (or any) of the repairs on his
list. The repairs you make are up to you and your mortgage holder, if you have
one and especially if they are on the check.

However, the only way to receive the additional money is to complete the repairs
that were depreciated in his estimate. You can do the repairs yourself, just keep
your material receipts as documentation. I would also take pictures.

Even if there was no depreciation it is always good to be able to prove repairs were
done in case you have damage again and need to make another claim.

The only reason you wouldn't get all the money
doing repairs yourself is if he had Overhead and Profit included in the estimate.
A homeowner is not entitled to make
a profit on a claim. If this claim just involves roofing then there probably
was
no Overhead & Profit included anyway.

Another reason you might not get all the additional money is if you have a contractor
do the work and he is cheaper than the adjusters estimate. You would only be entitled
to the difference between his estimate (less your deductible) and the amount you already
got.

Also, if you get a contractors estimate that is higher than the adjusters then call
the adjuster before signing a contract or having the work done and ask for a supplement
or ask him to negotiate the difference.
Good luck,
AskTheAdjuster back